The Cost Conundrum

The opacity of the American health care system can sometimes make that question tough to answer. Medical pricing can be anything but transparent, relying on a combination of insurance negotiation, sliding scales, and murky chargemaster divination to get to a final price. Asked what a procedure typically costs, many doctors say they don't know.

In a shocking and controversial exposé in Time magazine this year, Steven Brill exposed how arbitrary prices could be. "The health care market is not a market at all. It's a crapshoot," Brill wrote. "Everyone fares differently based on circumstances they can neither control nor predict."

Even hospital-systems administrators agree the way America does health care is flawed. Joe Robb, marketing director for the Eastern Washington region of Providence Health Care, says Providence wants to lead the effort in fixing health care pricing problems.

"The method for determining charges and the method for determining reimbursement have become disconnected from the process and lack transparency," a statement from Providence reads. "We know that this needs improvement and we are committed to working with both government and private insurers to improve the cost of care and the pricing information that patients have access to in the future."

In nine counties in Eastern Washington, the Breast, Cervical and Colon Health Program offers help. Through funds from the Centers for Disease Control and Prevention, the program pays for free access to screening tests for low-income individuals.

"We do pay for some colonoscopies in our program," says program coordinator Donna Oliver. "If there are people who aren't insured, we'd like them to have our information." The program pays cheaper Medicare rates — about $900 — to providers. Patients themselves don't have to pay anything.